MEDICARE: HAESUN CHO R.PH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	37421	CA

General Provider Information

NPI Number	:	1760851760
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HAESUN CHO R.PH

Provider Business Mailing Address
First Line	:	1680 COLORADO BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90041-1436
Country	:	US
Telephone Number	:	323-254-6736
Fax Number	:	323-254-8772

Provider Business Practice Location Address
First Line	:	1680 COLORADO BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90041-1436
Country	:	US
Telephone Number	:	323-254-6736
Fax Number	:	323-254-8772

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2015
Last Update Date	:	09/20/2015

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Directions to “ HAESUN CHO R.PH” Practice Location

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